| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
725 |
706 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
691 |
659 |
$19K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
373 |
371 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
125 |
125 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
675 |
663 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
64 |
64 |
$6K |
| 92015 |
Determination of refractive state |
381 |
381 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
119 |
112 |
$2K |